Pulmonary hypertension (PH) is an increase in blood pressure in the arteries which carry blood from the heart to the lungs, causing shortness of breath, fatigue, chest pain, dizziness, fainting and other symptoms. It is a progressive and serious disease, which can ultimately lead to heart failure or other potentially fatal complications. While it can strike anyone, at any age regardless of sex, race or social status, PH affects mainly women in their childbearing years.
Over the past decade, significant advances have been made in the evaluation, understanding and treatment of PH, leading to marked improvements in the survival and quality of life of patients. Today, treatments are available to help relieve the symptoms and slow the progress of the disease, but most patients with PH are still at risk of dying within a decade after diagnosis. Furthermore, since its symptoms are not specific and can be confused with that of other conditions, such as asthma or general fatigue, PH is hard to diagnose and is often confirmed only at the end stages of the disease, when it is more difficult to treat and control. All of which points to the need for more research and for better access to the expert assessment, care and lifelong monitoring services this small group of patients needs to continue to lead fulfilling lives.
The Centre for Pulmonary Vascular Disease provides ultra specialized care for patients with disorders of the lung circulation. It has been designated as a Centre of Excellence and is one of only two referral sites in Quebec for the evaluation of patients with PH. The Centre also performs leading-edge basic and clinical research and trains future PH specialists from around the world. Patients are referred to the Centre following the results of an echocardiogram, chest X-ray or other tests for further investigation aimed at confirming the diagnosis of PH, assessing disease severity and initiating treatment.
Hemodynamic measurement – measuring pressures and blood flows within the lung circulation – is essential to diagnosis, therapy and research. Right heart catheterization, in particular, – which consists of running a tube (a catheter) into a patient's heart to monitor bodily functions from second to second – is the only test that directly measures the pressure inside the pulmonary arteries and is the gold standard for establishing diagnosis of PH. Complete hemodynamic assessment is also indispensable to determine patient-specific therapy based on the type of PH and its cause(s), assess responsiveness to treatment and optimize therapy. Hemodynamic evaluations also yield data that enhance current understanding of the mechanisms of PH, paving the way for new, more effective treatments and procedures, and ultimately a cure.
“Pulmonary hypertension is a disease that relentlessly kills people, many of them young women. We need to be able to provide the best care and to push research forward towards a cure.”
– Dr. David Langleben, Chief, Division of Cardiology,
and Director, Centre for Pulmonary Vascular Disease
The hemodynamic measurements and other assessments can take up to several hours, and that time can be lengthened by research studies. The Centre now evaluates over 150 new patients per year. Each of these patients requires hemodynamic evaluation, and many of the other patients followed by the Centre also require repeat catheterizations in any year. We are currently placing extreme strain on a facility that also provides diagnosis and care for patients with coronary disease, acute heart attacks, and heart failure. Building a dedicated pulmonary hypertension facility is critical to be able to provide excellence at the Centre.
The Centre for Pulmonary Vascular Disease